The presence of microorganisms in follicular fluid and its effect on the outcome of in vitro fertilization-embryo transfer (IVF-ET) treatment cycles.

OBJECTIVES: To determine if the presence of microorganisms in follicular fluid of women undergoing in vitro fertilization-embryo transfer (IVF-ET) adversely affects the outcome of the treatment cycles. METHODS: Follicular fluid was collected from 86 women enrolled for IVF-ET at the National Hospital, Abuja from June 1, 2018 to December 1, 2018. Microscopy imaging and cultures were performed to identify bacteria and fungi in the follicular fluid and the vagina. Women with follicular fluid microorganisms were the test group while the controls were those without follicular fluid microorganisms. Fertilization and pregnancy rates were subsequently determined and their association with the presence of follicular fluid microorganisms was assessed using univariable and multivariable logistic regression modelling. RESULTS: The mean age and mean Body Mass Index (BMI) of the participants were 35(± 3.5) years and 28(± 4.9) kg/m2 respectively. Bacteria and fungi were isolated in 17% of the follicular fluid samples collected (n = 15/86). Most common isolates were Streptococcus spp. (n = 4/15), Staphylococcus aureus (n = 7/15), Enterococcus spp. (n = 4/15), Lactobacillus species (n = 2/15) and Candida albicans (n = 2/15). There was no statistically significant difference in the fertilization rates (adjusted odds ratio [AdjOR] 0.55, 95% confidence interval [CI] 0.04-7.34; P = 0.10) and pregnancy rates (AdjOR 4.02, 95% CI 0.56-28.92; P = 0.19) between the group of women with positive follicular fluid bacterial /fungal colonization as compared against those with negative follicular fluid colonization. CONCLUSION: Isolation of microorganisms from follicular fluid did not adversely affect fertilization and pregnancy rates following IVF-ET treatment cycles at the fertility centre of National Hospital, Abuja.

Review of Medically Indicated Preterm Births Due to Hypertensive Disorders in Pregnancy at a Tertiary Hospital in Abuja: Maternal Characteristics and Neonatal Outcome.

Background: Preterm birth is the delivery of a baby before 37 weeks of gestation. Hypertension in pregnancy has been found to be the most common cause of medically indicated preterm birth leading to significant neonatal mortality and morbidity. Objective: To evaluate the prevalence of medically indicated preterm births due to hypertension in pregnancy, the pattern of maternal characteristics and the immediate neonatal outcome. Study Design: A descriptive cross-sectional study of all medically indicated preterm births due to hypertensive disorders in pregnancy at National Hospital Abuja from 1st January 2008 to 31st December 2012. Results: The total number of births over the five-year period was 9055 with preterm births contributing 1075(11.9%), 523(48.7%) were spontaneous while 552(51.3%) were medically indicated. Hypertension in pregnancy was the indication for 254(23.6%) of the overall preterm births and 46% of medically indicated preterm births. Preeclampsia was the diagnosis in 77.1% of the cases of hypertensive disorders, 33.5% deliveries were between 34-36 weeks gestational age and the mean birth weight was 1.82kg. Conclusion: Hypertensive disorder was a major contributor to medically indicated preterm birth in this study with Preeclampsia as the predominant form. Proper preconception and antenatal care with institution of preventive measures for preeclampsia will help prolong gestation in at risk mothers to ensure better survival for neonates.

The Prevalence of Human Immunodeficiency Virus Infection among Pregnant Women in Labour with Unknown Status and those with Negative Status Early in the Index Pregnancy in a Tertiary Hospital in Nigeria.

Rapid HIV test in labour provide an opportunity for the identification of HIV positive pregnant women who should benefit from interventions to reduce the risk of mother-to-child transmission (MTCT) of HIV. Between November 2013 and June 2014 we conducted rapid HIV testing of pregnant women in labour at the National Hospital Abuja to determine the HIV seroconversion rate in pregnancy and the prevalence of HIV in pregnant women in labour with previously unknown status. HIV testing and counseling (HTC) was acceptable to 224 (99.6%) of the pregnant women who met the study criteria. The mean 'turnaround' time for test result was 288 minutes and 16.2 minutes for tests performed in the hospital laboratory and those performed at the point-of-care (labour ward) respectively. HIV seroconversion was detected in 2(1.2%) of the 165 parturients with initial HIV negative result early in the index pregnancy. HIV infection was detected in four (2.7%) of the 59 parturients with unknown HIV status. Secondary school level education was significantly associated with HIV seroconversion in pregnancy P < 0.001. HTC in labour using rapid testing strategy is feasible and acceptable in our setting. The introduction of HCT will lead to the diagnosis of HIV positive women in labour, appropriate interventions and prevention of MTCT of HIV.